| 多学科综合治疗71例儿童横纹肌肉瘤的效果评估 |
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| 引用本文： | 徐艳丽,施诚仁,谈珍,袁晓军.多学科综合治疗71例儿童横纹肌肉瘤的效果评估[J].中国肿瘤临床,2020,47(22):1145-1151. |
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| 作者姓名： | 徐艳丽 施诚仁 谈珍 袁晓军 |
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| 作者单位： | 上海交通大学医学院附属新华医院儿血液肿瘤科(上海市 200092) |
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| 摘 要： | 目的 评价横纹肌肉瘤（rhabdomyosarcoma，RMS）多学科诊疗草案重庆方案（CQ-RMS-2009）多学科综合治疗（multidisciplinary treatment，MDT）儿童RMS的有效性，探讨RMS预后因素。 方法 回顾性分析2006年5月至2016年4月于上海交通大学医学院附属新华医院治疗、年龄 <14岁RMS患儿临床资料。比较不同因素对RMS患儿长期生存的影响。 结果 71例RMS患儿纳入研究，男女比例1.84:1；中位诊断年龄为47（2~166）个月，中位随访时间52（15~165）个月。5年总体生存率（5-year overall survival，5y-OS）和5年无事件生存率（5-year event free survival，5y-EFS）分别为（61.9±5.1）%和（56.1±4.2）%。2006年5月至2009年12月收治的患儿5y-OS为（48.1±12.1）%，2010年1月至2016年4月收治患儿的5-OS为（73.3±7.9）%，差异具有统计学意义（P=0.042）；5y-EFS分别为（35.9±11.7）%和（69.8±8.7）%，差异无统计学意义（P=0.064）。单因素分析显示，病理类型、术后临床分组、治疗模式、危险度分组是影响RMS患儿总体生存率（overall survival，OS）的重要因素（均P<0.05）。多因素分析显示，术后临床分组及治疗模式是影响患儿预后的独立因素（均P<0.05）。 结论 当RMS确诊时，多数患儿处于中晚期，OS偏低，MDT模式可有效改善RMS患儿的预后，降低晚期患儿复发/疾病进展率，对于疾病复发/进展后的局部控制同样有明显效果。
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| 关 键 词： | 横纹肌肉瘤 多学科综合治疗 预后 儿童 |
| 收稿时间： | 2020-07-03 |
Therapeutic evaluation of multidisciplinary treatment for 71 cases of rhabdomyosarcoma in children |
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| Affiliation: | Department of Pediatric Hematology/Oncology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China |
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| Abstract: | Objective To explore the effectiveness and feasibility of multidisciplinary treatment (MDT) based on the CQ-RMS-2009 protocol and analyze the association of prognostic factors with the long-term survival of children with rhabdomyosarcoma (RMS). Methods Medical records of patients with RMS under 14 years of age at Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, from May 2006 to April 2016 were analyzed. The association of different factors with the long-term survival of children with RMS was compared. Results In total, 71 cases of RMS in children were included. The male to female ratio was 1.84:1, median age at diagnosis was 47 (2-166) months, and median follow-up time was 52 (15-165) months. The 5-year overall survival (5y-OS) and 5-year event free survival (5y-EFS) was 61.9%±5.1% and 56.1%±4.2%. From May 2006 to December 2009 and from January 2009 to April 2016, the 5yOS was 48.1%±12.1% and 73.3%±7.9%, respectively (P=0.042), and the 5y-EFS was 35.9%±11.7% and 69.8%±8.7%, respectively (P=0.064). The univariate analysis showed that the pathological subtypes, postoperative clinical group (P=0.025), treatment patterns, and risk groups were significantly associated with overall survival (OS)(P<0.05). Multivariate analysis revealed that the postoperative clinical group and treatment patterns were independent prognostic factors (P<0.05). Conclusions On diagnosis, most of the children with RMS are already in the middle and late stages with low OS. MDT could effectively improve the prognosis and reduce the rate of relapse/progression in children with RMS, and it has remarkable efficacy for local control of disease relapse/progression. |
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